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How I do it: dorsolateral approach for ventrolateral intramedullary cavernoma
Corentin Dauleac1,2, Isabelle Pelissou-Guyotat3
1Service de Neurochirurgie D, Hôpital neurologique et neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France. corentin.dauleac@chu-lyon.fr.
Acta Neurochirurgica
|January 5, 2020
Summary
This study introduces a ventrolateral surgical approach for spinal cord lesions, minimizing postoperative deficits. This technique is effective for lateral intramedullary lesions, improving patient outcomes.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Dorso-median myelotomy can lead to postoperative sequelae for small and lateral intramedullary lesions.
- A ventrolateral approach is proposed as an alternative to mitigate these complications.
Purpose of the Study:
- To describe a ventrolateral surgical approach for intramedullary lesions.
- To evaluate its efficacy in avoiding postoperative sequelae.
Main Methods:
- The approach involves cutting and retracting the denticulate ligament from its dural attachment.
- Careful spinal cord rotation under electrophysiological monitoring is crucial.
- Hydrodissection aids in gentle dissection of the lesion after pia mater incision.
Main Results:
- The ventrolateral approach maximized the absence of postoperative deficit in cases of lateral intramedullary lesions.
Conclusions:
- The ventrolateral approach is a viable and effective surgical strategy for specific intramedullary lesions.
- This technique offers a promising alternative for reducing postoperative neurological deficits.
